WISCONSIN INSURANCE QUESTION BANK
2026 INSURANCE LAW REVIEW UPDATED
A+
◉ Under which disability income policy provision might an insured
be considered totally disabled, even if working, following the loss of
sight in both eyes?
Recurrent disability
Residual disability
Presumptive total disability
Regular occupation total disability.
Answer: Presumptive total disability
◉ An insured currently has group coverage issued by different
health insurance companies. How will payment for medical
expenses typically be handled when both group policies provide
coverage?
The policy under which the individual was first insured will pay for
the expenses.
Payment will be made in accordance with the policies' coordination
of benefits provisions.
,The insured will collect the full amount of expenses from each of the
two insurers.
Payment of expenses will be made in accordance with the policies'
uniform provisions..
Answer: Payment will be made in accordance with the policies'
coordination of benefits provisions.
◉ In health insurance, initial notice about a potential claim:
May be required within a short time period
Usually results in rejection of the claim
Is sent to the attending physician's office
Must be submitted by the provider of services.
Answer: May be required within a short time period
◉ Group health insurance usually is written to cover:
People working for the same employer
At least 100 people
A minimum of 75 people
People who have no dependents.
Answer: People working for the same employer
,◉ In group health insurance, a group with a high average age usually
has:
Above average maternity claims
Above average total health claims
Little or no exposure to disability claims
Below average rates.
Answer: Above average total health claims
◉ One objective of a concurrent review provision in group health
insurance is to:
Reduce emergency admissions to the hospital
Reduce the number of second surgical opinions
Monitor length of stay in the hospital once the patient is admitted
Enforce the coordination of benefits provision.
Answer: Monitor length of stay in the hospital once the patient is
admitted
◉ Which statement is correct in regard to a disability income policy
with a 60-day elimination period?
, The premium will be less than that of a policy with a 90-day
elimination period.
The premium is waived for the first 60 days after policy issue.
The insured will be eligible to receive benefits beginning on the 61st
day of disability.
The first benefit payment will arrive on the 61st day of disability..
Answer: The insured will be eligible to receive benefits beginning on
the 61st day of disability.
◉ Why would an insurer limit the combined amount of disability
income benefits under multiple policies purchased by an insured
from the same or another company?
To make it unnecessary for the insured to complete more than one
proof of loss form per illness.
To make it unnecessary for the physician to submit multiple proofs
of disability for the same person.
To prevent the insured from receiving a benefit amount which might
make becoming disabled financially attractive.
To prevent the insured from purchasing additional medical coverage
immediately before a scheduled surgery..
Answer: To prevent the insured from receiving a benefit amount
which might make becoming disabled financially attractive.
2026 INSURANCE LAW REVIEW UPDATED
A+
◉ Under which disability income policy provision might an insured
be considered totally disabled, even if working, following the loss of
sight in both eyes?
Recurrent disability
Residual disability
Presumptive total disability
Regular occupation total disability.
Answer: Presumptive total disability
◉ An insured currently has group coverage issued by different
health insurance companies. How will payment for medical
expenses typically be handled when both group policies provide
coverage?
The policy under which the individual was first insured will pay for
the expenses.
Payment will be made in accordance with the policies' coordination
of benefits provisions.
,The insured will collect the full amount of expenses from each of the
two insurers.
Payment of expenses will be made in accordance with the policies'
uniform provisions..
Answer: Payment will be made in accordance with the policies'
coordination of benefits provisions.
◉ In health insurance, initial notice about a potential claim:
May be required within a short time period
Usually results in rejection of the claim
Is sent to the attending physician's office
Must be submitted by the provider of services.
Answer: May be required within a short time period
◉ Group health insurance usually is written to cover:
People working for the same employer
At least 100 people
A minimum of 75 people
People who have no dependents.
Answer: People working for the same employer
,◉ In group health insurance, a group with a high average age usually
has:
Above average maternity claims
Above average total health claims
Little or no exposure to disability claims
Below average rates.
Answer: Above average total health claims
◉ One objective of a concurrent review provision in group health
insurance is to:
Reduce emergency admissions to the hospital
Reduce the number of second surgical opinions
Monitor length of stay in the hospital once the patient is admitted
Enforce the coordination of benefits provision.
Answer: Monitor length of stay in the hospital once the patient is
admitted
◉ Which statement is correct in regard to a disability income policy
with a 60-day elimination period?
, The premium will be less than that of a policy with a 90-day
elimination period.
The premium is waived for the first 60 days after policy issue.
The insured will be eligible to receive benefits beginning on the 61st
day of disability.
The first benefit payment will arrive on the 61st day of disability..
Answer: The insured will be eligible to receive benefits beginning on
the 61st day of disability.
◉ Why would an insurer limit the combined amount of disability
income benefits under multiple policies purchased by an insured
from the same or another company?
To make it unnecessary for the insured to complete more than one
proof of loss form per illness.
To make it unnecessary for the physician to submit multiple proofs
of disability for the same person.
To prevent the insured from receiving a benefit amount which might
make becoming disabled financially attractive.
To prevent the insured from purchasing additional medical coverage
immediately before a scheduled surgery..
Answer: To prevent the insured from receiving a benefit amount
which might make becoming disabled financially attractive.
